5th Ed RACGP Standards Handout - Amazon Web Services

Update: The RACGPStandards 5th EditionNovember 2017Magali De CastroClinical Director, HotDoc

This session will cover Changes and new accreditation requirements under theRACGP 5th Edition Standards How the change in focus from ‘process’ to ‘outcomes’ willaffect practices Best tools and resources to help you prepare foraccreditation under the 5th Edition Standards

Transition phase between 4th & 5th editionThe Standards were launched on 26 October 2017.Practices undergoing accreditation before 31 October 2018can choose to be accredited under the 4th edition or the5th edition of the Standards.From 1 November 2018 all practices will be assessed againstthe 5th edition Standards.

What’s new in the 5th edition?New ‘adaptable’ structure of 3 modulesTaken from: tices-5th-edition.pdf

Language and focusFocus is now on outcomes and patients, instead of on prescribedprocesses or what the practice doesRestructured explanatory notesEach Criterion now has three sections: Why this is important: explains importance from a quality and safetyperspective. Meeting this Criterion: sets out ways to demonstrate that you meetthis Criterion Meeting each Indicator: list of mandatory activities and/or optionalways to meet the Indicator.Using ‘Must’ for mandatory and ‘Could’ for optional activities

More options for collecting patient feedback

New aspirational indicatorsC1.4C Our patients can access resources that are culturallyappropriate, translated, and/or in plain EnglishC3.1B Our practice evaluates its progress towards achieving its goalsQI3.2A Our practice follows an open disclosure process that is based onthe Australian open disclosure frameworkGP2.2D Our practice initiates and manages patient remindersGP4.1F Our practice records the sterilisation load number from thesterile barrier system in the patient’s health record when sterile itemshave been used, and records the patient’s name against those loadnumbers in a sterilisation log or list

Now mandatoryC5.2 u A Our clinical team can exercise autonomy, to the full scopeof their practice, skills and knowledge, when making decisions thataffect clinical careYou must: Give practitioners autonomy in relation to– Overall clinical care of their patients– Referrals to other health professionals– Requesting investigations– Duration and scheduling of appointmentsYou could: Maintain a policy specifying that practitioners have clinical autonomyto deliver evidence-based care, according to their scope of practice,skills and knowledge.

Now mandatoryGP5.2 u A Our practice has equipment that enables us to providecomprehensive primary care and emergency resuscitation, including:Pulse Oximeter

Now mandatoryGP6.1 u D Our practice has a written, practice-specific policy thatoutlines our cold chain processesYou must: Maintain a cold chain management policy and procedureYou could: Review the cold chain management policy once a year Discuss the cold chain management policy in team meetings

New mandatory indicatorsCriterion C1.5 – Costs associated with care initiated by the practiceC1.5 uA Our patients are informed about out-of-pocket costs forhealthcare they receive at our practiceC1.5 uB Our patients are informed that there are potential out-ofpocket costs for referred servicesYou must: Inform patients about out-of-pocket costs for healthcare they receiveat your practice Let the patient know when you are making a referral or requestinginvestigations that there may be a cost for the service

Costs associated with care initiated by the practiceYou could: Place information about the practice’s billing policy on your website Display billing information in waiting areas Explain the billing policy in person Provide contact details of service providers so the patient can findout about the costs for that service

New mandatory indicatorsC2.1 uE Our clinical team considers ethical dilemmasExamples of situations that might create ethical dilemmas in a practiceinclude: Patient–practitioner relationships (familial relationships, friendships,romantic relationships) Professional differences Patients giving gifts to the practitioner Emotionally charged clinical situations (eg unwanted pregnancy,terminal illness, or wishes to discuss euthanasia) Reporting to the state’s driver licensing authority that a patient isunfit to drive A patient’s request for a medical certificate if the practitioner doesnot believe that the patient’s condition warrants one

New mandatory indicatorsYou must: Document any ethical dilemmas that have been considered, and theoutcome or solution.You could: Develop a policy that explains how the team must manage ethicaldilemmas Discuss ethical dilemmas at clinical team meetings Provide a mentoring system where ethical dilemmas can be discussed Use an intranet or group email to pose common ethical dilemmas andsolutions for the clinical team to consider and discuss Display a notice in the waiting room listing ethical dilemmas thatpractitioners encounter, and how they generally deal with them

New mandatory indicatorsC2.2 uA Our practice obtains and documents the prior consent of apatient when the practice introduces a third party to the consultationYou must: Document in their health record the patient’s consent to the presenceof a third party arranged by the practice.You could: Maintain a policy about the presence of a third party during aconsultation Include information about the third-party policy in the inductionmanual for the practice team Place signs in the waiting room when medical or nursing students areat the practice and observing consultations Document the identity of a chaperone

New mandatory indicatorsC3.1 uA Our practice plans and sets goals aimed at improving ourservicesYou must: Plan and set business goals (eg service quality, staff retention, growth, efficiency, staffskills, new services, etc.)You could: Write a statement of the practice’s ethics and values Maintain a business strategy Maintain an action plan

New mandatory indicatorsC3.1 uC Our practice has a business risk management system thatidentifies, monitors, and mitigates risks in the practiceYou must: Maintain a documented risk management process Develop procedures to mitigate risksYou could: Maintain a risk register (eg risks associated with poor record keeping, IT systemfailures, inadequate systems for updating patients’ details and following up test results, etc) Maintain a log of risks if you are a small practice Keep a record of meetings where risks have been identified andactions agreed on to manage those risks

New mandatory indicatorsC4.1 uA Our patients receive appropriately tailored informationabout health promotion, illness prevention, and preventive careYou must: Document in the patient’s health record discussions or activitiesrelating to preventive healthYou could: Use preventive health guidelines and resources Hand out up-to-date pamphlets and brochures Provide information on the practice’s website Run preventive health activities, such as diabetic education groupsand groups to help patients quit smoking Have a reminder system to prompt patients of screening activities

HotDoc Inform ProContact the HotDoc team: 1300 468 362

New mandatory indicatorsC6.4 uF Our practice has a policy about the use of emailC6.4 uG Our practice has a policy about the use of social mediaYou must: Maintain an email policy and a social media policy (where applicable)You could: Put your email and/or social media policy on your website Have an automated response to patient emails that advises them ofwhen they are likely to receive a response.

New mandatory indicatorsQI1.1 uC Our practice seeks feedback from the team about ourquality improvement systems and the performance of these systemsYou must: Keep a record of feedback from the practice team about qualityimprovement systems.You could: Have notice boards or suggestion boxes the team can use tocontribute their ideas Create short surveys for the team to complete that are incorporatedinto a quality improvement plan

New mandatory indicatorsQI1.3 uB Our practice uses relevant patient and practice data toimprove clinical practice (eg chronic disease management, preventivehealth).You must: Show evidence that you have conducted a quality improvementactivity, such as a PDSA cycle or clinical audit, at least once every threeyears.You could: Use coded patient health information to audit patient health recordsand compare clinical practice Maintain a continuous improvement register Maintain a clinical audit based on a quality improvement plancompleted by the practice team

New mandatory indicatorsGP2.2 uE High-risk (seriously abnormal and life-threatening) resultsidentified outside normal opening hours are managed by our practiceYou must: Give diagnostic services the contact details of the practitioner whoordered the investigation Have a process for managing high-risk results identified outside ofnormal opening hours.

New mandatory indicatorsGP3.1 uC Our clinical team is trained to use the practice’s equipmentthat they need to properly perform their roleGP3.1 uD Our clinical team is aware of the potential risks associatedwith the equipment they use.You must: Demonstrate that the team has been provided with training on thesafe use of equipmentYou could: Keep training logs and/or development calendar Conduct annual performance reviews that identify learning anddevelopment goals Educate clinical team members so they know how to use the practiceequipment relevant to their role

ResourcesRACGP Standards 5th EditionResource Guide

ResourcesPatient Feedback GuideRACGP Questionnaire

ResourcesData entry table for patient feedback (self analysis)

ResourcesRisk matrix - Using email in general practice

ResourcesSocial media in general practiceOpen Disclosure Framework

Thank you for participating!Got a question?Email: md@hotdoc.com.au

Transition phase between 4th & 5th edition The Standards were launched on 26 October 2017. Practices undergoing accreditation before 31 October 2018 can choose to be accredited under the 4th edition or the 5th edition of the Standards. From 1 November 2018 all practices will be assessed against the 5th edition Standards.